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Objectives: This study aimed to investigate the association between ankle torque and performance-based tests, self-reported pain, and physical function in patients with knee osteoarthritis (OA). Patients and methods: The cross-sectional study was conducted with 39 individuals (24 females, 15 males; mean age: 57.3±6.2 years; range, 40 to 65 years) with knee OA between January 2014 and July 2015. Ankle torque was determined using an isokinetic dynamometer. The 40-m fast-paced walk test and a stair climb test were used to assess functional performance. Self-reported pain and physical function were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pearson's correlation coefficients were calculated to test correlations between the dependent variables (40-m fast-paced walk test, stair climb test, WOMAC pain and physical function domains, sex, age, body mass index, and radiologic evidence of OA) and the independent variables (mean plantar flexor torque and dorsiflexor peak torque). A multiple linear regression analysis was applied to quantify the association between the dependent and independent variables. Results: Dorsiflexor and plantar flexor peak torques in the concentric and eccentric modes were negatively correlated with the 40-m fast-paced walk and stair climb tests (r=-0.33 to -0.51, p=0.05). A negative correlation was found between concentric plantar flexor torque and the WOMAC physical function score (r=-0.35, p=0.03). No correlation was found between ankle torques and the WOMAC pain score (p>0.05). The multiple linear regression analysis showed that the eccentric plantar flexor and dorsiflexor torques were significantly associated with the stair climb test (β=-0.001, 95% confidence interval [CI]: -0.001 to 0.000, p=0.03, and β=-0.002, 95% CI: -0.004 to 0.000, p=0.05, respectively). No significant associations were found between concentric plantar flexor and dorsiflexor torques and the stair climb test (p>0.05). No significant associations were found between the ankle torques and the 40-m fast-paced walk test and WOMAC physical function (p>0.05). Conclusion: Ankle torque plays an important role in functional performance. Thus, ankle torque deficit, especially eccentric plantar flexor and dorsiflexor torques, may exert a negative influence on stair climbing performance in patients with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: The sit to stand transition (STS) is a task performed by those with knee osteoarthritis (KOA) with biomechanical modifications that may influence the lower limb load distribution. As a weight bearing task mainly performed in the sagittal plane, the presence of unilateral or bilateral KOA may lead to asymmetry during its performance.Research Question: Are the biomechanical and neuromuscular aspects of the sit to stand transition (STS) different between participants with unilateral and bilateral KOA?Methods: Twenty-eight participants were allocated as follows: unilateral KOA (OAUNI; n = 12) and bilateral KOA (OABI; n = 16). All participants were evaluated by means of kinematics (Qualisys Motion Capture System, Qualisys Medical AB, SUE), kinetics (Bertec Corporation's model 4060-08 Mod., USA), and electromyography (TrignoTM Wireless System, DelSys Inc., USA) during the STS. The variables calculated were the symmetry indices of the total support moment (TSM) and ground reaction force (ISGRF and ISTSM, respectively), magnitude of the TSM, individual joint contribution to the TSM, peak trunk flexion, hip, knee, and ankle range of motion, duration in seconds, the magnitudes of activation of the extensor and flexor muscles, knee extensors: flexor co-contraction indices and isometric knee extensor peak torques. Participants also answered the WOMAC questionnaire and performed the 30-second STS test (STS30).Results: The OABI got up from a chair with a lower TSM magnitude in the most affected limb (p = 0.040), used greater trunk flexion amplitude (p ≤ 0.034), and presented lower isometric KET (p = 0.039) and worse self-reported pain (p = 0.011) and physical function (p = 0.015).Significance: Participants with unilateral and bilateral KOA differ regarding lower limb kinetics and trunk kinematics while getting up from a chair, without modification in the lower limb intersegmental coordination or symmetry regarding ground reaction force or TSM distribution. [ABSTRACT FROM AUTHOR]

Knee osteoarthritis tends to modify the kinematics and kinetics of the sit-to-stand task. However, it is not clear whether the different degrees of knee osteoarthritis differentiate regarding these aspects. The objective was to identify if the trunk flexion, lower limb kinetics, total support moment, and individual joint contributions to the total support moment during the sit-to-stand task are different between patients with mild and moderate knee osteoarthritis. Sixty-two participants were grouped as follows: moderate knee osteoarthritis (n = 16), mild knee osteoarthritis (n = 25), and controls (n = 21). The participants performed a sit-to-stand task, which was analyzed using a 3D-motion system and a force plate. The three phases of the sit-to-stand task were analyzed. During Phase 1 , the moderate osteoarthritis group decreased the total support moment (P = 0.012). During Phase 2 , the moderate osteoarthritis group showed higher trunk flexion (P = 0.023) and lower internal hip and knee extension moments (P ≤ 0.001 and P ≤ 0.040, respectively) when compared to controls. Also in Phase 2 , both the mild and moderate groups used lower total support moment (P = 0.019, and P ≤ 0.001, respectively). When compared to the controls and mild osteoarthritis group , those with moderate osteoarthritis presented higher hip joint contribution to the total support moment (P ≤ 0.001 and P = 0.006, respectively) as well as lower knee joint contribution (P ≤ 0.003 and P = 0,013, respectively). Those with moderate osteoarthritis showed modified sit-to-stand movement pattern. While in Phase 3 a higher contribution of the hip joint to the total support moment was observed, during previous phases the individuals were able to decrease the load on the knee without influencing the lower limb load distribution. • Those with different degrees of knee osteoarthritis rise from the chair differently. • Moderate osteoarthritis presented an intersegmental incoordination at the end of the task. • Individuals with moderate osteoarthritis stand up using higher trunk flexion. • Individuals with mild/moderate osteoarthritis stand up with lower knee moment in the sagittal plane. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the effects of strengthening, neuromuscular and lumbopelvic stabilization exercises on strength, symptoms and physical function in men with mild knee osteoarthritis. METHODS: A total of 17 men with mild knee osteoarthritis participated in this study. Subjects underwent clinical and radiographic examinations and isokinetic strength evaluations and completed the Western Ontario & McMaster Universities questionnaire before and after an intervention program comprising strengthening, neuromuscular and lumbopelvic stabilization exercises twice per week for eight weeks. RESULTS: After the intervention program, subjects exhibited significant reductions in pain (P = 0.009), improvements in physical function (P = 0.015) and quadriceps and hip abductor strength. There was no change in hamstring and hip adductor strength or stiffness after the intervention program. CONCLUSIONS: An eight-week supervised exercise therapy program comprising strengthening, neuromuscular and lumbopelvic stabilization exercises may help reduce muscle weakness, pain and disability in men with early knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the relationship of hip abductor strength with external hip and knee adduction moments, pain and physical function, and trunk, pelvis, and hip kinematics in the frontal plane during walking in subjects with medial knee osteoarthritis. Methods: Twenty‐five subjects with medial knee osteoarthritis were evaluated through an isokinetic strength test for hip abductor, three‐dimensional gait analysis (kinetics and kinematics), and pain and physical function scores. Regression models were used to control the influence of other parameters such as pain, age, gender, severity, walking speed, mass, and height. Results: No relationship was found of hip abductor strength with peak of external knee adduction moment and knee adduction angular impulse. Hip abductor strength explained 17% of contralateral pelvic drop and 21% of hip adduction angle. In addition, hip abductor strength explained 4% and 1% of the variance in the WOMAC physical function score and 40‐m fast paced walk test, respectively. Conclusion: Considering the relationship of hip abductor strength with contralateral pelvic drop and hip adduction angle, specific exercises might improve physical function and lower limb dynamic alignment during gait. [ABSTRACT FROM AUTHOR]

• There is no association between uCTX-II and the knee joint load. • The uCTX-II level is associated with pain and physical function. • Knee joint load showed no association with pain and physical function. Considering the osteoarthritis (OA) model that integrates the biological, mechanical, and structural components of the disease, the present study aimed to investigate the association between urinary C-Telopeptide fragments of type II collagen (uCTX-II), knee joint moments, pain, and physical function in individuals with medial knee OA. Twenty-five subjects radiographically diagnosed with knee OA were recruited. Participants were evaluated through three-dimensional gait analysis, uCTX-II level, the WOMAC pain and physical function scores, and the 40 m walk test. The association between these variables was investigated using Pearson's product-moment correlation, followed by a hierarchical linear regression, controlled by OA severity and body mass index (BMI). No relationship was found between uCTX-II level and knee moments. A significant correlation between uCTX-II level and pain, physical function, and the 40 m walk test was found. The hierarchical linear regression controlling for OA severity and BMI showed that uCTX-II level explained 9% of the WOMAC pain score, 27% of the WOMAC physical function score, and 7% of the 40 m walk test. Greater uCTX-II level is associated with higher pain and reduced physical function and 40 m walk test performance in individuals with medial knee OA. [ABSTRACT FROM AUTHOR]

Background Knee Osteoarthritis seems to negatively impact ankle biomechanics. However, the effect of knee osteoarthritis on ankle muscle strength has not been clearly established. This study aimed to evaluate the ankle strength of the plantar flexors and dorsiflexors of patients with knee osteoarthritis in different degrees of severity. Methods Thirty-seven patients with knee osteoarthritis and 15 controls, subjected to clinical and radiographic analysis, were divided into three groups: control, mild, and moderate knee osteoarthritis. Participants answered a self-reported questionnaire and accomplished a muscle torque assessment of the ankle using the Biodex dynamometer in isometric, concentric and eccentric modes. Findings The mild osteoarthritis group (peak torque = 26.85(SD 3.58)) was significantly weaker than the control (peak torque = 41.75(SD 4.42)) in concentric plantar flexion ( P < 0.05). The control and mild osteoarthritis groups were not significantly different from the moderate osteoarthritis group (peak torque = 36.12(SD 4.61)) in concentric plantar flexion. There were no significant differences for dorsiflexion among the groups; however the control and moderate osteoarthritis groups presented large and medium standardized mean differences. The mild osteoarthritis group was significantly lower than the control and moderate osteoarthritis groups in the concentric plantar flexion by concentric dorsiflexion torque ratio. Interpretation Ankle function exhibited impairments in patients with knee osteoarthritis, especially in the plantar flexion torque, in which the mild osteoarthritis group was weaker than the control. Interestingly, patients with moderate knee osteoarthritis showed results similar to the control group in plantar flexion torque. The results raise the possibility of a compensatory mechanism of the plantar flexors developed by patients in more advanced degrees to balance other muscle failures. [ABSTRACT FROM AUTHOR]

Purpose: External knee moments are reliable to measure knee load but it does not take into account muscle activity. Considering that muscle co-activation increases compressive forces at the knee joint, identifying relationships between muscle co-activations and knee joint load would complement the investigation of the knee loading in subjects with knee osteoarthritis. The purpose of this study was to identify relationships between muscle co-activation and external knee moments during walking in subjects with medial knee osteoarthritis.Methods: 19 controls (11 males, aged 56.6±5, and BMI 25.2±3.3) and 25 subjects with medial knee osteoarthritis (12 males, aged 57.3±5.3, and BMI 28.2±4) were included in this study. Knee adduction and flexion moments, and co-activation (ratios and sums of quadriceps, hamstring, and gastrocnemius) were assessed during walking and compared between groups. The relationship between knee moments and co-activation was investigated in both groups.Findings: Subjects with knee osteoarthritis presented a moderate and strong correlation between co-activation (ratios and sums) and knee moments.Interpretation: Muscle co-activation should be used to measure the contribution of quadriceps, hamstring, and gastrocnemius on knee loading. This information would cooperate to develop a more comprehensive approach of knee loading in this population. [ABSTRACT FROM AUTHOR]